Diabetes-Savvy Mental Health Professionals Needed

It was 1991 or ’92 and Like Water for Chocolate by Laura Esquivel was the first book I read all the way through in something like three years. I’d been through a period—a long period—of burnout and depression, stemming from uncontrolled diabetes and a stressful job with a daily newspaper.

I’d tried to work through it, even moving from my job as a reporter into the night city desk slot when that editor tired of editing and wanted to go back to being a reporter. It didn’t work.

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The days of rewarding myself for completing a major project by reading the newest circa 1980’s Tom Clancy book were over; I could barely follow the plot line of a Reader’s Digest article, much less Clancy’s twisted plots and intrigue. I was thoroughly and completely nonfunctional.

I packed up my desk and left the paper. After all those years of chasing deadlines, constant schedule changes, never knowing when I went in what the day would bring, I felt like I’d run full speed into a very solid brick wall.

We all hear about the possibility of diabetes complications such as cardiovascular disease, kidney failure, blindness, and amputation, but diabetes has a “hidden” complication: depression.

Shelley, a friend of mine who has 30 years of Type 1 diabetes under her belt and a doctorate in psychology, works primarily with people who have cancer and their families, but pairs her personal and professional backgrounds to occasionally counsel distressed people with diabetes.

“Major depression is present in 11% of people with diabetes,” she says, compared to only 2% or 3% of people in the general population. “Elevated depressive symptoms are present in 31% of people with diabetes.” One-third of those who are both depressed and have diabetes are depressed at a level that affects functioning and quality of life.

Wow! That’s a lot! So where are all the psychologists who specialize in chronic conditions? And, more importantly, what are our diabetes advocacy groups doing to rectify the situation?

…And there this blog entry sat (I started writing it in June or July) as I tried, off and on, to find an answer to that question. While I managed to kind of scratch the surface, I’m still left mainly scratching my head.

I posed the question to Dr. William H. Polonsky, Ph.D., C.D.E., when I met him in August at the American Association of Diabetes Educators meeting in St. Louis. It sounded as if he had the same questions.

As he said in an e-mail he sent to me later, “In the very early ’90s, I had worked to put together a national directory of mental health professionals who had knowledge/skill/interest in diabetes.” However, he couldn’t get the support he needed to publish it.

When he approached the American Diabetes Association (ADA) about publishing the directory, “they decided that they did not want to do so, fearing possible legal ramifications. That was completely understandable and not unreasonable, but disappointing nonetheless,” he says.

The one and only copy of the directory did no more than occupy space on a shelf until last year when “after realizing how terribly out of date it was, I—with great sadness—tossed it.”

There is, however, good news on the horizon, Polonsky reported, saying that the ADA and the American Psychological Association (APA) have gotten together to sponsor a diabetes training program for psychologists. “The first four-hour training program was just delivered at the APA National Meeting in San Francisco” in August, Polonosky wrote. “So there is, finally, some movement in a positive direction.”

So I contacted the APA’s public affairs office: How many training sessions did they plan to have? Where would they be? How often? What’s the potential interest level?

I needed to talk to its continuing education department, I was told. Which kind of scratched its head when I called. So I called the ADA.

To make a long story short, there apparently was just that one “live” session, but APA members can do an online continuing education program. I was told somebody would get back to me with more information, but that was, oh, a month or so ago. I don’t know why I haven’t heard back but, in my 30-plus years in one form or another of communications, I’ve yet to find anybody who was reticent about spreading positive news.

I looked around for information on the program on the APA website, but couldn’t find it. However, I’m not an APA member, so it could be in an area I’m unable to access.

In the meantime, Polonsky still believes a national directory is a good idea and could perhaps be done in conjunction with his Behavioral Diabetes Institute.

“I will try again sometime in the next year or so,” he says. “After all, we don’t now need to publish hard copies; just need to get it on the Web.”

All he needs is some support.

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I am a mother of a teenager with type 1 diabetes. He is a teenager and has never gotten over the resentment of this life long disease. He is angry and does not accept this at all. I know all teens have hormones and issues, I just want to know what mental health services are out there to address this type of problem. Is there a connection with his mind and the damage from the irregular blood sugars over time. Is there a link to his emotional ability to cope and his body chemistry that day? Has there been any info on this. Where do I go for more help?
Sincerly a mom who just wants to take away the pain of this from her child.

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